Fracking has rapidly begun to move the United States toward energy independence, but at what price? Given the current state of affairs, in which the Middle East is in tatters, the Cold War with Russia looks to have returned and both India and China boast an accelerating appetite for fuel, this technological breakthrough could not have come at a better time. Yet the wealth promised by fracking comes at great expense: risks to the health of Mother Earth and her human population.

Fracking is a process of lateral underground drilling followed by the injection of a high volume of water combined with sand and chemicals in order to fracture shale, releasing oil and natural gas that would not otherwise be accessible by conventional drilling. Following decades of declining oil production in the United States, annual output in 2008 stood at 1.8 billion barrels. With the rapid expansion of fracking in the past five years, annual output has increased by 50 percent to 2.7 billion barrels.

Owing in large part to enhanced productivity, the cost of natural gas in the United States is only one-quarter of that paid in China and Japan, while the cost of gasoline in this country is roughly half that paid by consumers in Europe. Currently, nearly all global fracking occurs in North America, but its stellar success has generated profound interest in expanding wherever possible.

Proponents argue that aside from the ability to support energy independence and an enormous economic upside, fracking offers benefits to the environment, such as natural gas produces burns cleaner than coal. In truth, while burning natural gas releases fewer greenhouse gases, it still produces carbon dioxide, is nonrenewable and contributes to global warming.

In addition to its impact on the atmosphere, fracking is beginning to deplete another precious and limited resource: water. Fracking requires massive amounts of water, and in many active sites, aquifers are being drained at an alarming rate. Even without fracking, increasing population pressures already have placed substantial strains on water resources, particularly in arid regions such as the American Southwest, the Middle East and China. In addition to the huge water requirement, it stands to reason that copious lateral drilling, when combined with the injection of fluid mixed with chemicals and sand, carries a perpetual risk of contamination to drinking water.

The potential for geologic instability is a further concern particularly with a newer technique called zipper fracking. This involves drilling multiple parallel, lateral tracks, each of which is filled with a fluid slurry. I happened to be in Napa for my father’s memorial when, in the middle of the night, the family found itself in the epicenter of an earthquake. The crust of the earth is always moving, and zipper fracking in particular cannot but encourage the natural tendency of the earth to shift.

The National Institute for Occupational Safety and Health recently expressed safety concerns for workers exposed to chemicals during oil and gas extraction flow-back and production testing activities. The actual combination of agents added to the water and sand is considered proprietary. It turns out that workers may be subject to toxic exposures resulting from both synthetic and naturally occurring agents.

Benzene is one naturally occurring agent detected in the air during flow-back, according to NIOSH. Brief low levels of exposure can cause temporary drowsiness, dizziness, rapid heart rate, headaches, tremors and confusion. Long term, repeated or high levels of exposure can cause a form of leukemia. The Environmental Protection Agency has deemed benzene to be a carcinogen.

For one nation to be held hostage by another for its energy needs is unacceptable. Long before the thinly veiled invasion of Ukraine by Russia, gas pipelines to Europe were turned on and off at will. Energy has been used routinely for economic and political leverage. For decades the United States has projected its substantial diplomatic and military power on the international stage to advance and protect its interests — not the least of which is energy security. Fracking represents a landmark breakthrough insofar as it offers a domestic opportunity to develop energy security. Yet the risks to earth and sky are gripping as are the health risks to on-site workers.

To the extent that fracking continues — and it will — operations must be carefully regulated and expertly managed with responsible environmental impact and health risk assessments. Even more important, the fruits of this breakthrough technology should be directed toward the development of truly sustainable sources of energy for the long run.

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Ira “Kawika” Zunin, M.D., M.P.H., M.B.A., is a practicing physician. He is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.